Retroviruses are a family of viruses characterized by the presence of RNA genetic material and a special enzymatic protein known as reverse transcriptase. The human immunodeficiency virus, or HIV, is the most clinically significant human retrovirus. Antiretroviral drugs interfere with the infectivity and replication of HIV. Biomedical scientists have developed several classes of antiretroviral drugs, which target different steps in the HIV life cycle.
History
In 1987, Zidovudine was the first antiretroviral drug approved by the U.S. Food and Drug Administration for the treatment of AIDS. Originally approved for use only in patients with advanced disease, the FDA later approved zidovudine for the treatment of early stage HIV/AIDS. In 1994, zidovudine received approval for the prevention of mother-to-child HIV transmission during pregnancy, reports Dr. Susa Coffey of the University of California, San Francisco on the medical information website HIV InSite.
Types
The six groups of antiretroviral drugs available in the United States as of 2010 target HIV utilizing different mechanisms. The drug group names describe the mechanism of action. Antiretroviral drug groups include nucleoside/nucleotide reverse transcriptase inhibitors, or NRTIs; non-nucleoside reverse transcriptase inhibitors, or NNRTIs; protease inhibitors; fusion inhibitors; integrase inhibitors; and chemokine coreceptor antagonists, report Coffey and Dr. Laurence Peiperl on HIV InSite.
Use
Doctors prescribe antiretroviral drugs to suppress HIV replication and slow disease progression. The 2009 "Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents," issued by the U.S. Department of Health and Human Services, recommends concurrent use of drugs from two different groups of antiretroviral drugs. The preferred regimens include three drugs--a single drug from one antiretroviral group and two drugs from another group. Doctors select the specific combination of antiretroviral drugs on a case-by-case basis, taking into consideration the patient's medical history and health status.
Side Effects
Nausea, vomiting and diarrhea prove common with many antiretroviral drugs, reports Ian McNicholl, Pharm.D., on HIV InSite. Other side effects associated with antiretroviral drugs include fat redistribution, or lipodystrophy; headaches; numbness, tingling or pain in the extremities; elevated liver enzymes and liver toxicity; skin rashes; taste disturbances; fatigue; and muscle or joint pains.
Benefits
In "Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents," the authors state that antiretroviral therapy slows HIV/AIDS disease progression and reduces the risk for HIV-related death. Overall, antiretroviral therapy significantly prolongs survival among patients with HIV/AIDS. The authors further note that antiretroviral therapy can reduce the risk for HIV-associated disorders of the kidneys, liver and nervous system. Additionally, antiretroviral treatment of HIV-infected pregnant women substantially reduces the risk of transmission of the virus to the baby.
References
- U.S. Food and Drug Administration: Label and Approval History, Zidovudine
- University of California, San Francisco HIV InSite: Zidovudine (Retrovir)
- University of California, San Francisco HIV InSite: About the Antiretroviral Drug Profiles
- U.S. Department of Health and Human Services: Guidelines for the Use of Antiretroviral Agents in HIV-1-infected Adults and Adolescents
- University of California, San Francisco HIV InSite: Adverse Effects of Antiretroviral Drugs
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